Impact of a Nurse-Led Self-Care Educational Program on Fatigue and Psychological Distress in Women with Breast Cancer Undergoing Chemotherapy
TL;DR
Formal implementation of such programs in outpatient chemotherapy settings, especially in Kurdistan and Iraq, will empower patients' self-management against physical and psychological distress and improve quality of life during chemotherapy.
Abstract
Background: Chemotherapy remains the mainstay treatment strategy to combat early breast cancer as a major global health problem. Simultaneously, it causes various adverse effects, including fatigue and psychological distress. This study examines the impact of a Nurse-led self-care educational program in improving fatigue and psychological distress among women with early breast cancer undergoing chemotherapy. Methods: A quasi-experimental study with a non-equivalent design was conducted at Hiwa Hospital in Sulaymaniyah, Kurdistan Region of Iraq. Through non-probability purposive sampling, a total of 108 patients were recruited and allocated into two groups. The control group received standard care, while the intervention group received three sessions of a structured self-care educational program using a dedicated booklet. Both groups were assessed at baseline in the first cycle and post-test intervention after two months of receiving chemotherapy using a questionnaire including the FACIT-F and HADS. Data were analyzed with SPSS using descriptive and inferential statistics. Results: At baseline assessment, both control and intervention groups did not differ statistically (p-value >0.05). The post- intervention test confirmed that the nurse-led self-care educational program significantly improved the fatigue level (p-value <0.001), HADS-Anxiety (p<0.001), HADS-Depression (p<0.002) and fatigue severity (p<0.001). Positive strong correlation was found between anxiety and depression (ρ = 0.607, p<0.01) and significant negative correlations between fatigue and both anxiety (ρ = -0.293, p<0.05) and depression (ρ = -0.340, p<0.05). Clinically, fatigue was significantly affected by duration of diagnosis (p<0.015), type (p<0.017) and regimen (p<0.003) of chemotherapy. Psychological distress was influenced by la terality of breast cancer (HADS-A: p<0.049, HADS-D: p<0.045), age (HADS-D: p<0.016) and chemotherapy regimen (HADS-D: p<0.039). Conclusion: A nurse-led structured self-care educational program significantly shared in the improvement of fatigue and psychological distress in women with early breast cancer undergoing chemotherapy. Formal implementation of such programs in outpatient chemotherapy settings, especially in Kurdistan and Iraq, will empower patients' self-management against physical and psychological distress and improve quality of life during chemotherapy.